Surgical Site Infections

A surgical site infection or SSI is an infection that occurs following an operation in the part of the body where the surgery took place. Most patients who have surgery do not get an SSI. But one to three of every 100 patients who have an operation do develop this type of HAI.

SSIs can start at any time from two to three days after surgery until the wound has healed, which can take as long as three weeks after the operation. They are most likely to occur after a surgery on parts of the body that have a lot of germs, such as the gut. These infections can increase the patient’s length of stay in the hospital and chance of being readmitted after being discharged. SSIs also can occur following surgical procedures done at an outpatient surgery center.

Common symptoms of an SSI that occur around the surgical site are:

  • Redness, pain, tenderness, swelling or discoloration
  • A cloudy fluid draining
  • A bad smell
  • A delay in healing
  • Fever

Most SSIs can be treated with antibiotics. The antibiotic will depend on the germs causing the infection. Sometimes patients with these types of HAIs also need another surgery to treat the infection.

Your healthcare provider can help to prevent you from getting infected.

Preventing Surgical Site Infections or SSIs What Hospitals are Doing

  • Approximately half of all SSIs are considered to be preventable. In an attempt to reduce these HAIs from occurring, medical societies and government agencies have developed protocols for healthcare providers to follow.
  • To prevent SSIs, doctors, nurses and other healthcare providers should take the following steps:
  • Give the patient antibiotics before surgery starts. In most cases, antibiotics should be given within 60 minutes prior to the surgery starting and stopped within 24 hours following the operation.
  • Keep the patient warm. Studies show that patients undergoing surgeries have less chance of getting an SSI if they are not allowed to stay cold before and during surgery.
  • Clean their hands and arms up to their elbows with a special soap that kills germs just before the surgery is to begin.
  • If removing some of the patient’s hair around the surgery site, use electric clippers just before surgery. Do not shave the area with a razor as that can increase the risk for infection.
  • Clean the skin at the site with a special soap that kills germs.
  • Wear special hair covers, masks, gowns and gloves during surgery to keep the surgery area clean.
  • Monitor the patient’s blood sugar levels during and after surgery, especially if it is heart surgery. Controlled blood sugar levels help patients resist infection better.
  • Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each patient.
  • Some hospitals’ surgical teams use checklists to reduce errors in the operating room, including SSIs.

Preventing Surgical Site Infections or SSIs For Patients in the Hospital

Before surgery, patients should:

  • Tell their doctor about other medical problems they may have. Health problems such as diabetes and allergies could af fect the surgery and treatment.
  • Quit smoking. Patients who smoke get more infections.
  • Try to lose weight if they are obese. Overweight patients are more likely to have complications after surgery.
  • Avoid shaving near the area where the surgery will occur. Shaving with a razor not only irritates the skin, but makes it easier to develop an infection.
  • Ask if the surgeon uses special blankets, hats or booties during surgery to keep patients warm. Although operating rooms are often kept cold, patients who are kept warm tend to resist infection better than those who are allowed to stay cold.
  • Speak up if a healthcare provider tries to shave them with a razor. Ask their surgeon why this is necessary and talk about their concerns.
  • Ask if they will get antibiotics or be tested for MRSA before surgery.
After surgery, patients should:

Make sure that their healthcare providers clean their hands either with soap and water or an alcohol-based hand rub before they do any exams or change any wound bandages.

If they need a urinary catheter, remind the doctors and nurses that it should be removed as soon as possible. The longer a catheter is inserted, the better the chances of getting an HAI.

Make sure that family members and friends clean their hands before they enter the room and when they leave.

Make sure that visitors do not touch the surgical wound or dressings.

Preventing Surgical Site Infections or SSIs For Patients at Home

Before patients go home, they should make sure that they understand all of the doctor’s instructions, especially with regard to taking care of any wounds. Patients should know who to contact with any questions or problems that may arise after leaving the healthcare facility.

Once at home, patients should:

  • Always clean their hands with soap and water or an alcohol-based hand rub before and after caring for any wounds.
  • Call the doctor immediately if they have any symptoms of an SSI, such as redness, pain or swelling at the surgery site, drainage or fever.